Macugen® (pegaptanib sodium), Lucentis® (ranibizumab), and Eylea® (aflibercept) are selective vascular endothelial growth factor (VEGF) antagonists. VEGF is a secreted protein that selectively binds and activates its receptors located primarily on the surface of vascular endothelial cells. VEGF induces angiogenesis and increases vascular permeability and inflammation, all of which are thought to contribute to the progression of the neovascular (wet) form of age-related macular degeneration, a leading cause of blindness. VEGF has been implicated in blood-retinal barrier breakdown and pathological ocular neovascularization.

FDA APPROVED INDICATIONS

Macugen® is FDA approved for the treatment of neovascular (wet) age-related macular degeneration.

Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary.

The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language.